Nurse Care Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Atlanta • Ohio, Virginia • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Collaborating with healthcare providers and/or consumer to drive personalized health management
- Performing care management activities within the scope of licensure for members with complex and chronic care needs
- Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care
- Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance
- Collaborating with providers to assess consumer needs for early identification of and proactive planning for discharge
- Conducting clinical assessment to develop goals that address individual needs in order to develop and implement a care plan
- Monitoring and evaluating effectiveness of the care management plan and modifies as necessary
Requirements
- Requires a HS diploma or equivalent
- a minimum of 3 years of acute care clinical experience
- Current, active valid unrestricted RN license in applicable state(s) required
- Multi-state licensure is required if this individual is providing services in multiple states
- Home health/discharge planning experience preferred
- AS or BS in nursing preferred
- Certification as a Case Manager is preferred
- Requires 3 years full-time equivalent of direct clinical care experience to the consumer
- 5 years full-time equivalent of direct clinical care experience to the consumer preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
acute care clinical experienceclinical assessmentcare managementdischarge planningintervention planningcare plan developmentmonitoring and evaluationmedical necessity assessment
Soft skills
collaborationcommunicationproblem-solvingorganizational skills
Certifications
RN licenseCase Manager certification